Care Home: Hanna Schwalbe Home

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What the care home does well The people who use the service have opportunities to engage themselves with the services provided at a day care or in the community. The home makes exemplary efforts to meet the residents cultural, religious and dietary needs. The health and medical needs of the residents are met with the evidence that each person has their own general practitioner and that each one has had access to an optician, dentist and chiropodist. The setting and location of the home are comfortable for the people to live in. There are reliable and experienced staff to ensure that the residents` needs are met. What has improved since the last inspection? The home`s adult safeguarding policy has been updated. The manager has also obtained the local authority`s policy on adult safeguarding. These ensure people who use the service are well safeguarded. People who use the service, their relatives and professionals are consulted as part of the home`s quality assurance system. What the care home could do better: The staff need to attend training in basic food hygiene. People who use the service can benefit from meals handled, prepared and presented by trained and competent staff. CARE HOME ADULTS 18-65 Hanna Schwalbe Home 48 Leeside Crescent Golders Green London NW11 0LA Lead Inspector Mr Teferi Degeneh Key Unannounced Inspection 11th August 2008 09:00 Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hanna Schwalbe Home Address 48 Leeside Crescent Golders Green London NW11 0LA 020 8458 3810 020 8922 7454 judymkisharon@hotmail.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kisharon Management Committee of Hanna Schwalbe Home Mrs Judith Meshulam Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2007 Brief Description of the Service: Hannah Schwalbe is a registered care home for eight male adults with a learning disability. It is part of a range of community services managed by Kisharon, a charitable trust providing both education and care for Orthodox Jewish children and adults who have a learning disability. The home is a large corner house located in a quiet road close to the shops and local amenities of Golders Green. The main communal areas are located on the ground floor of the home and include a large lounge and a kosher kitchen/diner. The managers office occupies a corner of the lounge area. There is a secluded garden area and a shed at the end of the garden, which can be used for activities and also houses the washing machines. Most of the service users attend Kisharon College on a daily basis and have close links with their families and the local community. The weekly fees of the home depend on the assessed needs of service users but currently range from £700.00 to £800.00 per week. Inspection reports produced by the Commission for Social Care Inspection (CSCI) are available upon request from the manager or owner of the home or from the CSCI website at www.csci.org.uk. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection was undertaken over a period of six hours, starting at 9:00 am and concluding at approximately 3:00 pm. The manager and, Mrs Judith Meshulam, was present throughout the inspection. The inspection activity undertaken included a tour of the building, the examination of service users’ files including care records, the examination of health and safety records, and discussions with people who use the service and their relatives. The staff were also interviewed and observed. The home’s annual quality assurance assessment (AQAA), which was completed and returned to the Commission for Social Care Inspection (CSCI) as part of this inspection, has also been considered. The inspection revealed that the people who live at the home are well cared for. From observations and discussions the residents appeared to be relaxed and comfortable. The social, religious, dietary and leisure needs of the people who use the service are met by a committed manager and dedicated staff. What the service does well: What has improved since the last inspection? The home’s adult safeguarding policy has been updated. The manager has also obtained the local authority’s policy on adult safeguarding. These ensure people who use the service are well safeguarded. People who use the service, their relatives and professionals are consulted as part of the home’s quality assurance system. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are confident that their admission to the home is based on the outcome of their assessment and on the ability of the home meeting their needs. EVIDENCE: No new residents have been admitted to the home for a number of years. It is evident from the home’s AQAA and discussions with the manager that new residents are assessed before their admission to the home. The manager said there have been occasions when new applicants whose needs could not be met by the home have been turned down. The manager is a person responsible for completing the assessment of new service users. The files of the residents and a discussion with a relative of a service user confirmed that new residents have visited and spent time at the home as part of their assessment. The residents spoken to said they are satisfied with the home. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are good systems of reviewing assessments and care plans. These have enabled people who use service to identify and meet their needs. EVIDENCE: Five service user files which were randomly selected and examined contained evidence of reviews of care plans and assessments. The manager explained that the care plans are reviewed six monthly. It was evident from the care plans that families, residents and representatives from social services have attended the six monthly reviews. The manager has presented the reviews in a pictorial format, also known as the widget programme to enable people with communication difficulties to understand their care plans. The manager also confirmed that keyworkers explain the contents of the plans to the people who use the service. The residents were observed accessing the home’s communal areas without a restriction. They were seen interacting with the staff and each other, and appeared relaxed and comfortable. Discussions with the residents, staff and Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 10 the manager indicated that, where possible, the residents are encouraged and supported to do things for themselves. For example, some residents can make hot drinks and look after their personal care. Risk assessments have been completed for the residents. On the day of the inspection a resident was away with their family while two residents were going away on a holiday. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The arrangements put in place to engage people in the community and at the home are good. People who use the service are confident that their social, cultural, religious and leisure needs are met. The meals provided at the home meet the needs of the people who use the service. EVIDENCE: Seven of the eight people who use service were at the home during the early part of the inspection. Later on two residents left for their holiday and the others went out for a planned day trip. One resident was staying with their family. It was clear from activities programme, files and discussions with the residents and the manager that the residents are occupied with a range of work and leisure activities’ provided for them by the home. Each resident has a keyworker with whom they talk and plan their activities. A relative spoken to said “if the home was not meeting their religious needs they would not have chosen it”. The relative said they can visit the home at any time and can speak Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 12 to the manager or the staff whenever they wanted. It was obvious from conversations with the relative that they can visit a resident privately in a bedroom. The residents can also visit their families and stay over night or weekends with them. The residents spoken to said they liked their day activities but currently they are on a holiday. Discussions with the manager confirmed that all the residents are registered to vote on the electoral. The home has a policy on equality and diversity and has supported the people who use the service to practise their religion, culture, and way of life. From observations and records it was evident that the dietary needs of the people are met with the evidence of the menus, arrangements in the kitchens of food stuff and cooking practices. The residents and the relative spoken to are happy with the meals provided at the home. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the people who use the service are met by good management and provision of services. EVIDENCE: The manager said there is only one person on medication. She said the home has now changed the way it manages medication by receiving prescriptions from Boots in blister packs. An examination of the medication administration record sheet showed that there is a coding system to indicate whether or not medicines have been taken together with their reasons. The manager confirmed that all staff who administer medication have had training in medication administration. Also all staff have had training regarding the Boots medication administration system. The manager confirmed that all service users are registered with their own general practitioners. It was evident from the files that a speech therapist is involved for one person and people who use the service have access to opticians, dentists and chiropodists. The residents’ assessments and care plans showed that their personal, emotional, and social needs are identified and provisions are made to meet them. Discussions with the residents, a relative and the manager showed that support with personal care is provided for each person according to their needs. The residents looked Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 14 relaxed and satisfied on the day of the inspection. Those spoken to said they are happy with the home and with the staff. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, and 23 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The safety and wellbeing of the people who use the service are ensured by the home’s good adult safeguarding arrangements and the complaints procedure. EVIDENCE: It was evident from discussions with the manager that there have been no complaints or adult safeguarding issues since the last inspection. A care member of staff spoken to was confident in describing what adult safeguarding means and the action they would take in implementing the homes safeguarding policy. The manager has obtained the local authoritys safeguarding policy and has amended the homes safeguarding policy (December 2007) as required at the last inspection. The manager confirmed that all staff have atteded adult safeguarding training. The complaints procedure and the safeguarding policy of the home are also available in a pictorial form known as the widget programme. A relative spoken to said they know they can talk to the manager if they have a concern. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, and 30 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service are satisfied with the safe and good environment in which they live. EVIDENCE: A number of improvements have been made since the last inspection. These included provision of new lights in the kitchen, decorations and paintings of the walls to make the rooms brighter and a new floor covering in the lounge area. The bedrooms have been personalised with pictures, photographs, and drawings. There is a domestic assistant who comes to the home and cleans the rooms. All parts of the home were clean and free from bad smells. There is a well looked after garden at the back of the home. The manager said she was negotiating with the contractors in order to upgrade the bathroom and toilets. This includes the upgrading of the toilet room on the ground floor to a shower with a hand washbasin. The people spoken to said they like the home and their bedrooms. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, and 35 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service can be reassured that the staff employed at the home are vetted, trained and experienced to provide good quality of care. EVIDENCE: Five staff files were examined. All these contained evidence of CRB checks and two written references. The home has a recruitment policy including an equal opportunities policy. The manager explained the process of employing staff by saying that all vacant posts are adverised through local papers or magazines such as the Community Care. Applicants who are shortlisted attend interviews and the best candidates are selected. Currently there are twelve staff employed by the home. From the staff rota it is clear that each shift is covered by three staff. There are a waking night and sleeping-in staff for the night shift. The manager confirmed that each member of the staff at the home has a achieved a national vocational qualification (NVQ) level 3 in care. The staff have also attended various training including first aid, fire safety, adult protection, breavement, and medication. The manager has developed a training programme for the staff. An officer who recently visited the home Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 18 recommended that all the staff should attend basic food hygiene including the refresher programme. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is run by an experienced, knowledgeable and committed person. This means that there are systems in place to listen to the views of the people who use the service and to ensure the needs of the residents are met. EVIDENCE: The registered manager, Mrs Judy Meshulam, has held that position for over nine years and has recently been registered as the responsible individual. She is a member of the management committee, which is responsible for the home and is accountable to the board of trustees. The manager says she is a registered foster carer as well as being a member of a local school governing body. She has the registered managers’ award (RMA) and has great experience of supporting people with a learning disability in a care home or day care setting. The staff, people who use the service and a relative spoken to commented positively about the manager. For example, a relative said the manager is approachable and is easy to talk to. The views of another relative Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 20 were quoted in the last inspection report: “I have nothing but praise for the manager”. The manager said people who use the service are continually consulted about their views of the service. Letters and completed forms seen confirmed that the manager has sent out quality assurance survey forms to relatives, professionals and visitors and these have been returned and analysed. The result of the surveys shows that the people who completed the forms are satisfied with the home. The home also receives complementary letters from visitors and relatives. Among a number of such letters, one reads: Thank you for giving such a wonderful holiday. The manager also confirmed that she has developed an action plan to improve the service. From conversations with the manager and an examination of the files it was clear that the people who use the service manage their finance with support. The manager said she is an appointee for all the residents just for signature purposes but the accounts are in the residents’ names. Certificates of safety checks and records of health and safety activities were seen and found to be up to date. These included, records of portable electrical appliances (30/07/08), electrical wiring system (30/01/08), and a certificate of gas boiler (22/04/08;). Records showed that fire alarms have been checked and recorded weekly. An officer who visited regarding the food hygiene of the home recommended that all staff attend training in relation to basic food hygiene. There has been one recorded incident since the last inspection. This has been dealt with appropriately following the home’s procedures. Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 3 3 X 3 X X X X 30 X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA32 Regulation 18(1) Requirement All care staff who work at the home must attend food hygiene training. People who use the service will benefit from staff who are trained and able to handle, prepare and serve meals following food hygiene requirements. Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hanna Schwalbe Home DS0000010431.V368632.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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